Endoscopic treatment for chronic Achilles tendinopathy

Abstract

This study presents our experience and results in patients with Achilles tendinopathy treated with an endoscopic technique. Eight patients with chronic tendinopathy of the Achilles underwent endoscopic treatment. A distal portal is created 2 cm proximal of the lateral margin of the tendon insertion. A slotted cannula is inserted in a proximal direction and toward the midline. A 4.5 mm diameter arthroscope is advanced through the cannula. An additional portal, equidistant to the lateral portal, can be created at the medial distal level if we need to access the most medial and distal part of the tendon. Pathological tissue is eliminated while performing multiple longitudinal tenotomies with a retrograde knife blade. Clinical outcome was assessed according to the Nelen scale. Clinical results were scored as excellent, with all patients able to return to pre-procedure sports activity without limitations. There were no complications in any case. Endoscopic treatment yielded satisfactory results with lower morbidity than other reported techniques.